4613 BAKER DR 2019-06-10 - Laserfiche WebLink

PERMIT APPLICATIOI"r BUILDINt ECHANICAL/ PLUMBING /SIGN I' IPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES J 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-88571(E)everette s everettwa. ov www.everettwa. ov/ ermits P@ 9 I 9 p (Blue'or Black Ink`Only P ease) PROJECT SITE I NFORMATION. v v ' PROJECT SITE ADDRESS: 4(01' ti -1✓(l..SDR. PROPERTY TAX#: DO441-4 oo4.0 1200 LEGAL for new construction: Short Plat/subdivision $4I A Lot No. (attach copy of long legal description) SE,>; DgA4/1,4A5 .,CONTACT INFORMATION OWNER NAME: LISA+ Stfr ESI ei.,oi.ALA TENANT NAME(If Commercial): --- OWNER MAILING ADDRESS: STREET[M4/47--( 9Q-1V 1 Earle CT /� Q p CITY V,14'I 1..-fro0 STATE WIN ZIP 1 7911'5 OWNER PHONE: 2.047--4(- 884-0 OWNER EMAIL: ,3I.O-040(14r0(iI('tP.r. WAN CONTRACTOR NAME: Y'ESSE PIA o) 1? E',11C tziarroA4 C'Tt0^1 CONTRACTOR ADDRESS: STREET t00y4�-n rG r o ?L NSC CITY LP ?Pt STATE \N ZIP ctS1 CONTRACTOR PHONE: 24449 - BrS4 " 1146 CONTRACTOR EMAIL: lesser fAvielo @ i2600•coM CONTRACTOR LICENSE#(REQUIRED): P40E.,4C toOlc%141► CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): lb PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR XOTHER(Please Specify) Nitar+tT( r CONTACT NAME: IIc�ER.` � } CONTACT PHONE: 2 p(p -(op 4.-9(,I I CONTACT EMAIL: (-doert(el,`joat-,a940.141.-11uyh ,Com, BUILDING PERMIT APPLICATION; f > v Existing Use of Building: )n5U-- moi 4 k NR te1.4nt.C, Contract Price of Work:$ .7•'t rI v'5 0i Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other_ ccl.o.4-J - 056,i Building Type: "FR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Additiontemodel ❑Repair ❑T.I. OSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: - ��tt,c, i14oHsc re to 1c-e-A inCi,kckn se.r►'N 4 ) k:�C1�P.Y 1 Ana 44,c,on srtoo r ma(AV- but* w;tkA NA.) aoc-ivve-c'. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL`PERMIT:APPLICATION<' > { PLIUMBING,PERMIT%APPLICAT ON Type of Project: _New _ Addn _Alteration _Repair Type of Project: New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump 4- Toilet 0 Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater ( Bathtub 0 Urinal Gas Piping Boiler 4, Lavatory(Wash Basin) 0 Drinking Fountain Water Heater Refrigeration 3 Shower 0 Floor Drain 2. Gas Fireplace Wood Stove i Kitchen Sink&Disposal O Grease Trap 1 Gas Range Ducting ( Dishwasher 0 Roof Drains Clothes Dryer Hookups Other: 2_ Clothes Washer 0 Medical Gas Range Hood 0 Water Heater Other: 8 Exhaust Fan Z Sink(Service/Bar/Mop/etc.) Other: SPRINKLER I SUPPRESSION.SYSTEM`: Chemical or Water I No. of Heads ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance.I am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only "khq PERMIT# \`' Owner/Authorized Agent Signature Date (Revised 9/23/2016)